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The effect of running on knee joint cartilage

Is it harmful or beneficial for knee joint cartilage?

Running has a beneficial effect on cartilage nutrition and metabolic exchanges in knee cartilage tissue. Although cartilage thickness also appears to decrease temporarily, this decrease is not greater than what is seen during walking. This effect in thickness is not affected by age or running time. These are findings from a recent review, which consequently concluded that running seems to have a general positive effect on knee cartilage. 

A decrease in knee cartilage thickness and T2 relaxation time after running was reported in the included studies. There was also a short-term decrease in COMP content up to 30 minutes which was no longer significant 1 and 2 hours after running. Thus, running showed no persistent negative effects on knee cartilage volume. Further research of higher methodological quality remains needed.

> From: Dong et al., Phys Ther Sport 47 (2021) 147-155 (Epub ahead of print). All rights reserved to Elsevier B.V.. Click here for the online summary.

Expert opinion

Although the quality of studies is not ideal, the results from this review are in line with those of other reviews which point to beneficial effects of axial load on different joint tissues.

This review should therefore be another encouragement not to advise patients to take up swimming to avoid “damaging their knees”. Naturally, there is nothing wrong with swimming itself (especially if patients enjoy it), but the message to avoid joint loading may not only have an effect in tissue quality (as the review shows) but also promote fear of movement and decrease participation in the long term, which would cause further deconditioning and pain.

The main take-home message, then, should be to empower patients to keep up loading activities they enjoy and not promote avoidance (unless, of course, there are other contraindications to physical activity).

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